Phobias and Panic Disorder

Everyone feels scared at times. But sometimes, fear can come up in a situation that isn’t expected. This fear stops us from going about our usual routines or working towards our goals. Phobias and panic disorder are two examples of mental illnesses that can lead to these problems.

Phobias and panic disorders are included in a group of mental illnesses known as anxiety disorders. Anxiety disorders are among the most common type of mental health problems, affecting one out of every ten Canadians. In spite of this startling statistic, anxiety disorders are not well understood, and those experiencing these conditions are often regarded as “weak, self-indulgent or undisciplined”.

Panic attacks may be totally unpredictable, last ten to thirty minutes and are unrelated to any specific “trigger.” They can strike at any time, in any place and cause incredible, overwhelming fear. Panic disorder involves repeated and unexpected panic attacks. It involves physical sensations like a racing heart, shortness of breath, chest pain, dizziness, shaking, sweating or nausea. Some people feel like they’re having a heart attack or suffocating, or fear that they are dying. However, a panic attack goes away on its own. Panic attacks can be a normal reaction to a stressful situation or a part of another mental illness. With panic disorder, panic attacks seem to happen for no reason.

In fact, the fear generated by a panic attack can be so intense, it actually causes people to become anxious about the possibility of future attacks; this is called a panic disorder. Panic disorders cause so much anxiety for people, they avoid any situation where they might have a panic attack, and are terrified to leave their homes (agoraphobia). Panic disorders affect approximately two million Canadians. Statistics show that of the people seeking treatment, two-thirds of them are women. The disorders often first appear in teenagers and young adults. The cause of panic disorders is not known, however it is believed that genetics (a family history), stress and biological changes in the brain contribute to the illness. In addition, traumatic life events such as the death or serious illness of a loved one, an accident or rape, childhood abuse or even happy events such as the birth of a child, can increase the risk of developing panic disorders.

Unlike panic disorders, phobias have “triggers” that are identifiable. People with phobias have an overwhelming, irrational fear of “things,” such as objects, situations or animals. Two common phobias include heights and dogs. We all feel scared of certain things at times in our lives, but phobias are different. People change the way they live in order to avoid the feared object or situation. For example, many people feel nervous about flying, but they will still go on a plane if they need to. Someone who experiences a phobia around flying may not even go to an airport. Phobias can affect relationships, school, work or career opportunities, and daily activities. It is believed that phobias develop from events or people that influenced the person in their developmental years. A history of family break-up, parental aversion to socializing, another influential adult’s phobias or a traumatic event can be linked to phobia in a young person. Generally there are two different categories of phobias:

Specific Phobia – As the name suggests, people with this type of phobia are terrified of something very specific. Examples include fear of heights, flying, certain animals or insects, water (hydrophobia), weather conditions (such as thunder and lightning), public transportation, needles, tunnels, bridges and open spaces. There are many other examples of specific phobias, each as unique as the individual who experiences them.

Social Phobia – Social situations provoke tremendous fear and self-consciousness for those with a social phobia; included in this category is the fear of performing in public. To avoid the feelings of terror and humiliation, or the potential of having a panic attack in public, those with a social phobia will go to great lengths to avoid being in any situation where they will be surrounded by other people.

Fear is a natural part of our lives; it is an instinctive human reaction that protects us from danger. However, when fear becomes a dominating force, overwhelming our ability to function on a day-to-day basis, it may be the result of a phobia or panic disorder.

The symptoms can be so overwhelming that the person may believe that they are going to die. In fact, it is not unusual for these individuals to end up in the hospital emergency department numerous times, convinced that they are having a heart attack. The physical symptoms of phobias and panic attacks include:

Anyone can experience panic disorder or a phobia. No one knows exactly what causes phobias or panic disorder, but they are likely caused by a combination of life experiences, family history, and experiences of other physical or mental health problems.

If you, or someone you care about, show the symptoms of a phobia or panic disorder, the first thing you need to do is talk with your family doctor. An initial medical examination should be done, to rule out any underlying physical causes for the symptoms. For example, anemia and thyroid problems mimic the symptoms of anxiety. If your family doctor identifies a phobia or panic disorder, there are a number of different treatments available to help you. Psychotherapy, relaxation and breathing techniques, and medication have proven to be very effective. If you have a phobia, behaviour therapy could also be recommended, to help you become desensitized to the “thing” that causes your fear.

You need to be an active member of your mental health team. Take a proactive role in your wellbeing and make lifestyle choices that are mindful and healthy.

Join a support group if your community has one:It is important for you to network with others who are also asking questions about their illness and looking for coping strategies to help them with their disorder;

Eat a healthy diet:A well-balanced, nutritious diet is important for overall health;

Avoid alcohol, caffeinated beverages and illegal drugs:While it is tempting to seek emotional relief from substances, they often increase your anxiety and can trigger panic attacks;

Stop smoking:Try to cut down or even quit smoking. As you cultivate a healthy body, you will feel great about getting rid of this habit;

Exercise:Get active and stay active. Physical activity has been proven to improve mood and a sense of calm;

Stress management:Find a course on stress management and seek ways to reduce your stressors and your perception of them;

Try meditation and other activities that calm the mind:Sitting or moving meditations such as tai chi and yoga are beneficial to calming the mind;

Get a good night’s sleep:You need sufficient sleep to help you feel good the next day, so be sure to get enough rest at night.

Most people who experience problems with anxiety recognize that their fears are irrational but don’t think they can do anything to control them. The good news is that anxiety disorders are treatable. Recovery isn’t about eliminating anxiety. It’s about managing anxiety so you can live a fulfilling life. Some physical health problems, such as heart or thyroid problems, can cause anxiety symptoms. Your doctor will look at all possible options to make sure that another medical problem isn’t behind your experiences.

Counselling can be very helpful in managing anxiety, and it’s often the first treatment to try if you experience mild or moderate problems. Cognitive-behavioural therapy (CBT) is shown to be effective for many anxiety problems. CBT teaches you how thoughts, feelings and behaviours all work together. Counselling for panic disorder and phobias, in particular, may also include exposure. Exposure slowly introduces feared things or situations.

Support groups may be a good way to share your experiences, learn from others, and connect with people who understand what you’re experiencing. There are many self-help strategies to try at home. Small steps like eating well, exercising regularly, and practicing healthy sleep habits can really help. You can practice many CBT skills, like problem-solving and challenging anxious thoughts, on your own. Ask your support team about community organizations, websites, or books that teach CBT skills. And it’s always important to spend time on activities you enjoy and connect with loved ones.

Antianxiety medication may help for short-term difficulties or situations, but it usually isn’t the best option for long-term use. Some types of antidepressants can help with anxiety, and they can be used for longer periods of time. It’s important to remember that medications can’t change all of the thoughts, feelings, and behaviours that drive anxiety, so counselling is usually recommended. Some people take medication until their anxiety is controlled enough to start counselling. Everyone feels scared at times. But sometimes, fear can come up in a situation that isn’t expected.

Many people who experience anxiety disorders like panic disorder or phobias can feel ashamed about their experiences. They may blame themselves or see their experiences as a problem with their personality rather than an illness. It’s important to recognize the courage it takes to talk about difficult problems. Supporting a loved one in distress can be difficult, especially if you don’t fear the object or situation yourself. You may also be affected by a loved one’s anxiety. For example, some people seek constant reassurance from family and friends, or demand that they follow certain rules. These behaviours can lead to stress and conflict in relationships. But with the right tools and supports, people can manage anxiety well and go back to their usual activities. Here are some tips for supporting a loved one:

Remember that thoughts and behaviours related to anxiety disorders are not personality traits.

A loved one’s fears may seem unrealistic to you, but they are very real for your loved one. Instead of focusing on the thing or situation itself, it may be more helpful to focus on the anxious feelings that they cause. It may also help to think of times you have felt intense fear to empathize with how your loved one is feeling.

People naturally want to protect a loved one, but ‘helping’ anxious behaviours (like taking care of everyday tasks that a loved one avoids) may make it harder for your loved one to practice new skills.

If a loved one’s behaviours are affecting you or your family, it’s a good idea to seek family counselling. Counsellors can help with tools that support healthy relationships.

Be patient—it takes time to learn and practice new skills. Take time to congratulate a loved when you see them using skills or taking steps forward.

Set your own boundaries, and seek support for yourself if you need it. Support groups for loved ones can be a good place to connect with others and learn more.

Reach out for help

Because of the stigma surrounding mental illness, people with these disorders are often called “overreacting or hysterical” by others. Coupled with their own feelings of embarrassment and guilt, these individuals often do not seek help for a condition that is treatable. You can also contact the Canadian Mental Health Association – Calgary Region for more information at
(403) 297-1700 or email: info@cmha.calgary.ab.ca.